Abstract
ABSTRACT.The last decade has witnessed substantial progress in acquiring diagnostic biomarkers for the diagnostic workup of cerebrovascular disease (CVD). Advanced neuroimaging methods not only provide a strategic contribution for the differential diagnosis of vascular dementia (VaD) and vascular cognitive impairment (VCI), but also help elucidate the pathophysiological mechanisms ultimately leading to small vessel disease (SVD) throughout its course.Objective:In this review, the novel imaging methods, both structural and metabolic, were summarized and their impact on the diagnostic workup of age-related CVD was analysed. Methods: An electronic search between January 2010 and 2017 was carried out on PubMed/MEDLINE, Institute for Scientific Information Web of Knowledge and EMBASE.Results:The use of full functional multimodality in simultaneous Magnetic Resonance (MR)/Positron emission tomography (PET) may potentially improve the clinical characterization of VCI-VaD; for structural imaging, MRI at 3.0 T enables higher-resolution scanning with greater imaging matrices, thinner slices and more detail on the anatomical structure of vascular lesions.Conclusion:Although the importance of most of these techniques in the clinical setting has yet to be recognized, there is great expectancy in achieving earlier and more refined therapeutic interventions for the effective management of VCI-VaD.
Highlights
Advanced neuroimaging methods provide a strategic contribution for the differential diagnosis of vascular dementia (VaD), and help elucidate the pathophysiological mechanisms leading to small vessel disease (SVD) throughout aging.[6]
This review briefly summarizes some of the most promising neuroimaging techniques addressing brain structural and metabolic changes in cerebrovascular disease (CVD)
Novel neuroimaging methods offer an enthusiastic debate on the interplay between aging, neurodegeneration and vascular disease; one interesting topic involves, for instance, the pattern of cortical thinning exhibited by CVD and other related cognitive disorders
Summary
Vascular cognitive impairment (VCI) is an umbrella term denoting a continuum of behavioral and cognitive deficits associated with cerebrovascular disease (CVD).[1,2,3] CVD is estimated to occur in one third of the population, often being recognized as a pathological finding on conventional Magnetic Resonance Imaging (MRI).[1,3,4] Depending on the site, intensity, and severity, CVD may either cause or contribute to further cognitive impairment.[2,5]Over the last decade, there has been substantial progress in acquiring diagnostic biomarkers for the diagnostic workup of neurodegenerative and vascular disorders.[2,6] In vivo brain imaging has been applied for several decades to identify brain structural (diseasespecific atrophy) and functional (disease-specific hypometabolism) abnormalities. Advanced neuroimaging methods provide a strategic contribution for the differential diagnosis of vascular dementia (VaD), and help elucidate the pathophysiological mechanisms leading to small vessel disease (SVD) throughout aging.[6] One example of the growing importance of structural and functional imaging markers on the diagnostic work up of dementia is that the fifth edition of the DSM (2013) has changed to include a broader definition of cognitive impairment, the neurocognitive disorder. These criteria stress the need to support the etiological diagnosis with neuroimaging markers.[6]
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